By Kenneth Daniels, OD, FAAO, Dipl. ABO
Feb. 22, 2023
Presbyopia is an inescapable fact of life that afflicts everyone, but it creates an opportunity for the clinician to assist the patient in multiple ways. With the proper patient selection and education this opportunity allows us to provide enhanced visual function and versatility, via glasses and/or contact lenses. As one of the many with presbyopia, I can empathize and, therefore, can present the various options from my own perspective and clinical experience.
I utilize daily disposable multifocal contact lenses to enable me to have better visual function in the office and various activities, complemented with eyewear for other times. For myself, and a majority of my presbyopic patients, I have found that the NaturalVue Enhanced Multifocal 1 Day Contact Lenses have become a significant first-choice option and a practice differentiator.
We use a philosophy of fitting the “3 Ps” (pediatrics, the parents of the peds and presbyopes). As such, not only can the NaturalVue Enhanced Multifocal work for myopia management (another topic), but it yields a more balanced binocular vision for presbyopes with its EDOF (extended depth of focus) design. The unique optics of the lens allows for a high level of fitting success for hundreds of my patients, which, in turn, leads to word-of-mouth referrals.
A Lens that Keeps Patients In Your Practice & Reordering from You
Two important key performance indicators we track are patient retention and contact lens reorder rate. Both of those crucial metrics are helped by prescribing NaturalVue lenses.
In all cases, we will provide adequate trial lenses to assure patient acceptance and adaptability to the lens design. Once we finalize the fitting, which is an easy process, with reduced chair time with the NaturalVue Multifocal lenses, we try to encourage annual supplies. We encourage annual supplies with all our contact lens fits, thus, we can monitor individual patient activity and know if they are ordering through our office or from alternative sources.
We work diligently to retain orders from patients, but online retailers remain a challenge, especially as we enter a likely recession where patients are more attuned to cost. For every online authorization that we might receive, we proactively check vision plan benefits and available rebates and then communicate this information to the patient prior to completing an authorization request. In many of these cases, we have found the request was never made by the patient, and if it was, we have been able to educate the patient to utilize our office for purchasing with an equal or better cost, and ordering ease, via our website.
NaturalVue is a great help in boosting our ability to compete with online retailers, as it cannot be purchased online, due to the business policies of Visioneering Technologies, Inc., the manufacturer of NaturalVue Multifocal. VTI believes in protecting product integrity, the eyecare practitioner (ECP), and patient health. Our process allows the patient to utilize our office services to re-order lenses by calling (24/7) or by using our website to complete a contact lens order request. These orders are tended to immediately upon receipt, even on weekends.
To make this work, we will educate the patient at the fitting, and upon dispensing, about the various ordering options, as well as about the competitive pricing and cost savings we can offer, and most importantly, professional services for all of their eye health needs. We avoid “selling the patient,” but instead, are “educating the patient.” The high quality of the NaturalVue lens, which makes it impressively comfortable, combined with the inability to order the lens from an online retailer, means that patients return to us for long-term care.
Present Annual Supply as Cost-per-Day Vs. Cost-per-Year
The potential cost of multifocal lenses is significantly higher than spherical or toric lenses. When presented in terms of an annual cost, which is a major mistake, it can seem financially forbidding. However–and this is for all lenses–when presented as “cost per day,” it is much more palatable.
For example, for patients with no insurance coverage: If you present the patient’s annual supply cost as $920, even after subtracting the manufacturer’s rebate ($100), the total is $820, so many patients may think twice before purchasing. However, if you present their daily cost as approximately $2.25 per day, noting how many days per week the patient wears the lenses, you will have greater success at getting that patient to make a purchase.
For patients with vision plan benefits: If you present your patient’s annual supply cost as $920, then subtract their vision plan benefit (for example $150), and the manufacturer’s rebate (for example $100), you have $670 per year. The patient may still be hesitant to buy a year’s supply. But, if you present their daily cost as approximately $1.80 per day, noting again how many days per week they wear the lenses, this will allow you to be much more likely to capture that purchase.
When the patient says that they would prefer to go online or to a big-box store, you can feel secure that you will capture the sale if the patient is wearing NaturalVue lenses.
Some patients may argue, or still wish to seek purchasing alternatives, but when they find that NaturalVue lenses cannot be obtained outside your office, they will be back. According to the rules of the Fairness to Contact Lens Consumers Act (FCLCA), the patient has the right to seek products from other vendors, but VTI’s policies limit the availability by non-authorized vendors.
A Lens With Optimal Vision & Comfort that Patients Are Happy They Purchased
Not only is it likely that patients will purchase, and reorder, NaturalVue lenses from you; they will be happy that they did.
We use NaturalVue Multifocal as a first-choice lens in the majority of cases for presbyopes for the simple reason that it is not a modified “me too” design. The vast majority of lenses on the market utilize aspheric, concentric or annular, designs. NaturalVue was the first to incorporate an extended depth of focus (EDOF) design into a daily disposable modality.
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NaturalVue Multifocal is also a more favorable choice because it enables us to serve the needs of our patients with a large range of power options: +4.00 to -12.00 in 0.25 diopter steps. Importantly, this lens can address the needs of the low toric patient. When there is an astigmatic need in the range of 1.00 to 1.25 cylinder, the majority of spherical based multifocal designs cannot address the issue, unlike the EDOF (extended depth of focus – virtual pinhole) effect of Natural Vue, which minimizes this disparity. We explain EDOF as a large wave going through a wide pipe where the edges are out of focus.
The virtual aperture/pinhole effect of the NaturalVue Multifocal compresses the wave into a thin beam to reduce peripheral defocus, but refines the focusing with enhanced clarity at distance while providing consistent enhancement at intermediate and near. EDOF is not unique to the NaturalVue Multifocal contacts lens, but it is also used in astronomical telescopes and intraocular lenses due to the enhanced optics. To further educate the patient, we will also have them view an eyechart uncorrected and then place a pinole occluder in front of them to demonstrate the clarity achieved, which enhances the discussion and the concept.
The cutting-edge technology behind NaturalVue Multifocal makes this a lens our patients love to wear due to the enhanced quality and versatility of their vision for everyday activities, as well as its tremendous comfort. The VTI policy of commitment to independent practitioners also encourages patient retention.
Kenneth Daniels, OD, FAAO, Dipl. ABO, is past president of New Jersey Society of Optometric Physicians (2017-2018), Adjunct Assistant Clinical Professor: PCO, member of the AOA Strategic Communications Committee and owner of Hopewell-Lambertville Eye Associates. Dr. Daniels is a paid consultant for Visioneering Technologies. To contact him: firstname.lastname@example.org